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August 26, 2025

Unionization in Healthcare: Examining Working Conditions and Worker Mental Health Outcomes in Hospital Settings

Key Points

Unionization significantly reduces the likelihood of screening positive for posttraumatic stress disorder, and lowers perceived stress levels.
Survey data from 1,466 hospital workers shows unionized employees benefit from predictable raises and better job security.
Propensity score matching was used to control for confounding factors affecting health and work conditions among these workers.
These findings suggest that improved unionization could have a positive impact on healthcare worker mental health and job satisfaction.

Abstract

This study examines the association between unionization, working conditions, and mental health among hospital healthcare workers. Survey data were collected from 1,466 unionized and non-unionized hospital workers in a city in Western Pennsylvania. Using propensity score matching to control for confounding factors, we found that unionization is significantly associated with predictable raises, not holding multiple jobs, not working overtime due to pressure, access to dental insurance and retirement programs, receiving higher raises, experiencing less workplace harassment. Additionally, unionization is linked to a lower likelihood of screening positive for posttraumatic stress disorder and lower perceived stress levels.

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